Study finds IMRT Superior to 3D Conformal RT for Mesothelioma, According to Surviving Mesothelioma

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Swiss researchers say ability to control radiation beams means longer remission and lower recurrence.

The use of HCRT [IMRT] increases the probability of local control as compared to 3DCRT by improving target volume coverage.

Surviving Mesothelioma is reporting on a new study in Radiation Oncology comparing two methods of modern radiotherapy for malignant pleural mesothelioma.

3D Conformal Radiotherapy (3DCRT) allows doctors to sculpt radiation to the size and shape of the mesothelioma tumor, hitting the targeted tumor with higher dozes while minimizing radiation to surrounding tissues and organs. Intensity Modulated Radiation Therapy (also called Highly Conformal Radiotherapy) is similar but takes the process a step further with the use of a multi-leaf collimator, which uses independently-moving metal “leaves” to further mold the shape of the beams to the shape of the tumor.

In the latest study, researchers compared the two techniques in 39 malignant pleural mesothelioma patients. Prior to their RT treatment, the patients had undergone neoadjuvant (prior to surgery) chemotherapy and extrapleural pneumonectomy to remove their diseased pleural lining, one lung, and other at-risk tissues. Afterward, 25 of the study subjects were treated with 3DCRT while 14 underwent IMRT. The authors compared overall survival, disease-free survival, and the pattern of cancer recurrence in each group.

After matching for age, gender, tumor type and stage, and completeness of surgery, the study found a recurrence rate of 72.7% with 3DCRT but just 27.3% with IMRT. IMRT also appeared to increase the amount of time it took for mesothelioma to start growing again by 49% over 3DCRT. When cancer did start growing again in the IMRT group, it was more likely to be in an area outside of the original radiation field whereas 16% of 3DCRT patients experienced recurrence within the treated area.

“The use of HCRT [IMRT] increases the probability of local control as compared to 3DCRT by improving target volume coverage,” the authors conclude in Radiation Oncology. Overall survival rates with the two types of RT were about the same at just under 2 years. The original study was conducted at University Hospital Zurich and appears in Radiation Oncology. (Krayenbuehl, Jerome, et al, “Clinical outcomes of postoperative highly conformal versus 3D conformal radiotherapy in patients with malignant pleural mesothelioma”, January 24, 2014, Radiation Oncology, Epub ahead of print,

For nearly ten years, Surviving Mesothelioma has brought readers the most important and ground-breaking news on the causes, diagnosis and treatment of mesothelioma. All Surviving Mesothelioma news is gathered and reported directly from the peer-reviewed medical literature. Written for patients and their loved ones, Surviving Mesothelioma news helps families make more informed decisions.

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Michael Ellis
Cancer Monthy
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